抗精神病药物对精神分裂症患者心功能的影响

Effect of antipsychotic drugs on cardiac function in patients with schizophrenia

目的观察抗精神病药物对精神分裂症患者心功能的影响。方法回顾性选取2020年5月—2021年5月云南省精神病医院收治的精神分裂症患者190例,根据用药不同分为奥氮平组70例、富马酸喹硫平组60例和利培酮组60例,3组均连续治疗6个月。比较3组心电图异常情况、心功能参数[左心房内径(LAD)、每搏输出量(SV)、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室舒张末期内径(LVEDD)]及心电图与不同年龄段之间的关系。结果用药6个月后,心电图异常率分别为奥氮平组(31.43%)、富马酸喹硫平组(26.67%)、利培酮组(11.67%),3组患者组间比较差异有统计学意义(χ^(2)=8.090,P<0.05);3组患者组内心功能参数比较差异均有统计学意义(P<0.05或P<0.01);3组患者SV、LVEF、LVEDV组间比较差异均无统计学意义(F/P=0.324/>0.05,1.702/>0.05,0.581/>0.05);LAD、LVEDD组间比较差异均有统计学意义(F/P=12.199/<0.01,17.340/<0.01);随着年龄的增长,心电图异常率随之增加。结论精神分裂症患者服用抗精神病药物治疗时,心功能一定程度上受到影响,要求临床医师在用药过程中密切监测心脏结构和功能的变化,发现问题及时处理,避免发生意外。

Objective To observe the effect of antipsychotic drugs on cardiac function in patients with schizophrenia.Methods One hundred and ninety schizophrenic patients admitted to Yunnan Provincial Psychiatric Hospital from May 2020 to May 2021 were retrospectively selected and divided into olanzapine group(70 cases),quetiapine fumarate group(60 cases)and risperidone group(60 cases)according to different medication,all three groups were treated continuously for 6 months.The ECG abnormalities,cardiac function parameters[left atrial diameter(LAD),stroke volume(SV),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic diameter(LVEDD)]and the relationship between ECG and different age groups were compared.Results After 6 months of medication,the abnormal rate of ECG was 31.43%in olanzapine group,26.67%in quetiapine fumarate group and 11.67%in risperidone group,the difference between the three groups was statistically significant(χ^(2)=8.090,P<0.05);There were significant differences in the parameters of cardiac function among the three groups(P<0.05 or P<0.01);There was no significant difference in SV,LVEF and LVEDV among the three groups(F/P=0.324/>0.05,1.702/>0.05,0.581/>0.05);There were statistically significant differences between LAD and LVEDD groups(F/P=12.199/<0.01,17.340/<0.01);With the growth of age,the abnormal rate of ECG increases.Conclusion When schizophrenics take antipsychotic drugs,their cardiac function is affected to a certain extent.Clinicians are required to closely monitor the changes of cardiac structure and function during the medication process,and timely deal with problems found to avoid accidents.